Risk factors for Perinatal Mortality Due to Asphyxia Among Emergency Obstetric Referrals in a Tertiary Hospital.
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Date
2012-03
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Abstract
Objectives: To evaluate the clinical, behavioral and health-care
associated risk factors of intrapartum perinatal mortality (IPPM).
Design: Prospective cohort study.
Setting: Labor room and postnatal wards of a teaching hospital in
North India.
Participants: Pregnant women were eligible for enrolment in the
study if period of gestation at delivery was 35 weeks or more or
baby weighed at least 2000 g at birth, index pregnancy was not
booked in antenatal clinic of the study hospital and fetus was
delivered within 24 h of admission in the hospital.
Methods: Information about antenatal care and events
surrounding labor and delivery were retrieved from antenatal care
records, referral notes, hospital clinical records and interview of
mothers. Multivariate analysis was conducted using forward
stepwise logistic regression analysis.
Main Outcome Measure: IPPM was defined as asphyxiaspecific
stillbirth or asphyxia-specific early neonatal death.
Results: Among 248 emergency obstetric referrals during the
study period, rate of IPPM was 8% (20/248, 18 fresh stillbirths and
2 asphyxia-specific neonatal deaths). District hospitals and
community health-centers/first referral units contributed threefourths
of all referrals. On logistic regression analysis significant
risk factors for IPPM were presence of obstructed labor (OR: 23,
95% CI: 1.9-275.8), father engaged in unskilled labor (OR: 10,
95% CI: 1.3-77.7) and absence of urine examination during
antenatal period (OR: 5.5, 95% CI: 1.8-16.3).
Conclusions: Low socioeconomic status, inadequate antenatal
care and poor intrapartum care due to unskilled birth attendance
are risk factors of IPPM.
Description
Keywords
Asphyxia, Mortality, Neonate, Stillbirth
Citation
Rani Shikha, Chawla Deepak, Huria Anju, Jain Suksham. Risk factors for Perinatal Mortality Due to Asphyxia Among Emergency Obstetric Referrals in a Tertiary Hospital. Indian Pediatrics. 2012 March; 49(3): 191-194.